Aortic arch digital arteriography: an alternative technique to digital venous angiography and routine arteriography in the evaluation of cerebrovascular insufficiency.

Digital arch arteriography is a technique in which the cervicocerebral vasculature is studied by injecting small amounts of contrast material (20 ml or less of diatrizoate meglumine 60%) into the aortic arch. It was used as the initial phase of arteriography in 100 patients with cerebrovascular disease. Five to ten series were obtained in various projections to evaluate the cerebrovascular system. Because suboptimal studies may be repeated, only 3% of carotid bifurcations were suboptimally visualized by digital arch arteriography as compared with 17% by film arch angiography. Intracranial vascular pathology was identified less reliably than with selective angiography. Digital arch arteriography yielded excellent studies in cases when digital venous angiography was suboptimal (20%). Digital arch arteriography may be preferable to digital venous angiography as a screening test in patients with significant cardiac or renal dysfunction because of the lower contrast load.